When to seek help from a fertility specialist

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People may consider speaking to a fertility specialist if they:

• are under 35 and have been trying to conceive for over a year without success
• are 35 or older and have been trying for 6 months without success
• are older than 40 and are considering pregnancy
• have irregular menstrual cycles outside of 21–35 days
• painful or absent menstrual cycles
• have known fertility issues
• have had two or more consecutive pregnancy losses
• have a partner with known fertility issues

Fertility starts to decline more significantly between 35 and 39 years, making early evaluation and intervention more critical.

Females of 40 years or above might consult with a fertility specialist soon after they decide to try to conceive. The decline in egg quality and quantity is more pronounced, and there may be a higher risk of pregnancy complications.

A fertility specialist can provide a thorough assessment and discuss the best options. These might include oral medications to induce ovulation or assisted reproductive technologies (ART) such as IVF or the use of donor eggs.

Even before trying to conceive, a preconception checkup can be beneficial for identifying potential health issues that might affect fertility. This is a good time to discuss any concerns with a healthcare professional, as well as how to optimize a person’s natural fertility.

Recurrent pregnancy loss may indicate an underlying issue that could be genetic, hormonal, anatomical, or related to the immune system.

However, medical professionals often debate the definition of recurrent pregnancy loss.

The American Society for Reproductive Medicine defines it as experiencing two or more pregnancy losses, while the European Society for Human Reproduction and Embryology defines it as three consecutive losses.

A fertility specialist can help identify potential causes and offer treatment options.

Sexual dysfunction, including erectile dysfunction in males and painful intercourse (dyspareunia) in females, can affect a couple’s ability to conceive.

Causes can be psychological, physiological, or a combination of both. Addressing these issues can sometimes require a multidisciplinary approach, including counseling, medical therapy, or other treatments.

• Amenorrhea (no period): The absence of menstruation could indicate issues such as hormonal imbalances, extreme weight loss or gain, stress, or serious health conditions such as polycystic ovary syndrome (PCOS) and thyroid disorders, which can affect fertility. Amenorrhea can also be due to pregnancy.
• Irregular periods: This can suggest ovulatory disorders, making it difficult to predict ovulation and time intercourse for conception. It can also suggest other health conditions, such as PCOS.
• Heavy periods: This may be a symptom of conditions such as fibroids or endometriosis, which can also affect fertility.

If a person has menstrual period issues, they may need to speak with a fertility specialist.

Sexually transmitted infections (STIs) such as chlamydia and gonorrhea can lead to reproductive issues, including pelvic inflammatory disease (PID). This can cause damage to the fallopian tubes in females and lead to infertility.

Early treatment of STIs is crucial to prevent long-term reproductive harm.

People with any of the following conditions may wish to speak with a fertility specialist when they decide to start trying to conceive.

• Endocrine disorders: Conditions like thyroid disease (both hyperthyroidism and hypothyroidism) or uncontrolled diabetes can affect menstrual cycles and ovulation, thus impacting fertility.
• Autoimmune disorders: Certain autoimmune disorders can affect fertility in both direct and indirect ways, including through ovarian or testicular damage or by affecting implantation.
• Cancer and cancer treatments: Treatments such as chemotherapy and radiation can significantly affect fertility. For those planning cancer treatment and considering their future fertility, consulting a fertility specialist about preservation options before treatment is crucial.
• PCOS: This common endocrine disorder can cause irregular menstrual cycles and ovulation issues, leading to difficulties in getting pregnant.
• Uterine fibroids or endometriosis: Both conditions can affect the uterus’s lining, making it difficult for an embryo to implant or leading to other fertility challenges.

Here are the answers to some commonly asked questions regarding fertility.

When should I be concerned about fertility?

For people under 35 years old who have been actively trying to conceive for more than 1 year without success, it may be time to seek professional advice.

For a person or couple where the female is 35 years or older, the window shortens to 6 months. This is due to the natural decline in fertility that occurs with age.

Females who are 40 years or above may wish to consult with a fertility specialist soon after they decide to try to conceive. Egg quality can decline after this age, and there may be a higher risk of pregnancy complications.

People with known fertility issues, including conditions affecting sperm count or quality, may also consider consulting a specialist even sooner.

How do I know if my fertility is OK?

Regular menstrual cycles are one of the most accessible indicators of ovulatory function. Cycles lasting between 25 and 35 days suggest regular ovulation, a crucial factor for natural conception.

For males, factors like semen volume, sperm count, mobility, and morphology play significant roles. Abnormalities in these areas could signal fertility issues.

Females over 40 years who are considering pregnancy may wish to contact a fertility specialist about their options.

It is important to seek advice from a fertility specialist sooner rather than later.

They can offer specific diagnostic tests and treatments tailored to a person’s situation. These may include ART, surgery, medication, or lifestyle changes to improve their chances of conceiving.

Early intervention can often lead to better outcomes when dealing with fertility challenges.